UPDATE-- DAY 0
Okay, had the set-up/simulation today. My appointment was at 10:00 AM. The first part was meeting with the doctor and his assistant for "patient education." They went over all the possibilities (including the bad stuff that are long shots). In my situation, the main real concerns are hemmie and bowel problems. I have hemmies (I can't spell the whole word) that are very significant and pronounced but RARELY give me any problems. They indicated there is a high probability that I will have some significant irritation. They suggested that I buy some Prep. H pads and use them instead of TP from the beginning of the SRT. Since I don't always listen, I suspect I will do TP and switch to the pads at the first sign of irritation. I'm not sure, but they pick that as my #1 SE, probably. Another will probably be bladder irritation. I'll have more urgency and frequency but probably not incontinence per se. The other main SE is fatigue but they said most of their PC folks pretty much carry on -- ie: it should not cause me any major problems. Also, I will have weekly appointments with the doctor to see how things are going and of course more frequent appointments if I have problems.
I forgot to ask again about the totality of my SRT. Last I remember, it was going to be 38 sessions and 68.4 total Gy. I will ask again next time I'm there. Also, they did mention they are radiating the prostate bed and not the entire pelvic/node area. I also asked about PSA tests. They said the first one post-SRT will be about 12 weeks after.
One very disturbing item: It will take them a week to come up with a plan and they like to have folks start before Wednesday or at the latest Wednesday during a week. They don't like to just start with 2 days and then have a weekend break. This means that it is possible I will not start next week, but the week after. It depends when the plan is developed. Also, they will not know what slots are open until the plan is done and they are ready for me. So, I still don't know if we can avoid conflicts with my work schedule. I showed them my schedule; it differs every day. They do want me the same time every day. Brief vent: Sometimes the best plans go awry. I saw the doctor a couple of times well in advance of my BCR just so I could quickly start SRT if needed. I had a back injury which delayed my PSA (anticipating doing SRT right away) by 2 weeks. Then the doctor went on vacation (another week's delay) and now these logistical things! Of course, it's always a relief to delay unpleasantness, but this isn't good! End of vent.
Oh, continuing with my saga. The next part of my day was the actual simulation. They put me on a table with a bean bag like contraption. Air is let out of the bean bag, basically forming a rough mold around me. Then they put a catheter up my butt and injected a very small amount of contrast material. They then took some cat scans. They also put some markers on me. They then looked at the results (10 minutes -- doctor and technician). Finally, the moved the markers a millimeter or so and put 3 tattoos on me (each hip and pubic area). These will be used for alignment.
In terms of dress, I had to strip from the waste down and put on a hospital gown.
They said the first tx. will consist of a trial run, followed by the real thing. That might take 25-40 minutes. After that, probably 12 minutes maximum. Today's events took 90 minutes. The technician was very nice, carefully explaining everything he was going to do just before doing it so there were no surprises.
My next real update will probably be day 1, which will probably be in 2 weeks.
In the interim, I would welcome any and all comments, especially from those who have been throught this!
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27